2011-02-11T07:39:43-06:00 2010-04-30 NOVAK FRANCELLA LLC ONE PRESIDENTIAL BLVD SUITE 330 BALA CYNWYD PA 19004 990 2009-05-01 223052612 PAINTERS DISTRICT COUNCIL 711 HEALTH AND WELFARE FUND PAIN 8567932501 27 ROLAND AVENUE No 200 MOUNT LAUREL NJ 08054 harry harchetts 8567932501 2011-02-11 LOUIS VERZELLA CPA 6106689400 2011-02-11 2009 2016-02-24 21:20:13Z harry harchetts 27 ROLAND AVENUE No 200 MOUNT LAUREL NJ 08054 43652884 0 X N/A X 1990 PA The Plan provides health benefits (including major medical, hospital, dental, vision and prescription drug), life insurance, accidental death and dismemberment and weekly disability benefits to eligible members and their dependents of the Painters District Council 711 of the International Union of Painters which represents painters and workers in allied trades throughout the State of New Jersey. 10 10 1 0 0 0 0 22681757 19566100 656841 362806 14575 220913 23353173 20149819 11000 21434572 20483479 23527 33144 0 0 1130081 1221773 22588180 21749396 764993 -1599577 21129036 19986130 79796 115156 21049240 19870974 The Plan provides health benefits (including major medical, hospital, dental, vision and prescription drug), life insurance, accidental death and dismemberment and weekly disability benefits to eligible members and their dependents of the Painters District Council 711 of the International Union of Painters which represents painters and workers in allied trades throughout the State of New Jersey. 0 0 THIS IS A MULTI-EMPLOYER PLAN WHICH HAS BEEN ESTABLISHED TO provide health benefits (including major medical, hospital, dental, vision and prescription drug), life insurance, accidental death and dismemberment and weekly disability benefits to participants who have met certain eligibility requirements. 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 3 0 1 1 0 0 0 0 0 0 0 10 10 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 X FRANK M VACCARO & ASSOCIATES INC 8567932501 27 ROLAND AVE SUITE 200 MOUNT LAUREL NJ 08054 X harry harchetts 1.00 X 0 0 0 KENNETH EMMONS 1.00 X 0 0 0 joseph estevez 1.00 X 0 0 0 MICHAEL KISIELEWSKI 1.00 X 0 0 0 VINCENT LANE 1.00 X 0 0 0 CLEMENT SOMMERS 1.00 X 0 0 0 JOHN ANDERSEN 1.00 X 0 0 0 THOMAS CIRIGNANO 1.00 X 0 0 0 CHARLES KOMOROSKI III 1.00 X 0 0 0 ROBERT SUCHODOLSKY 1.00 X 0 0 0 0 0 0 0 0 0 0 FRANK M VACCARO & ASSOCIATES INC 27 ROLAND AVENUE SUITE 200 MOUNT LAUREL NJ 08054 FUND ADMINSTRATION 948242 HORIZON BLUE CROSS BLUE SHIELD OF NEW JE PO Box 820 NEWARK NJ 07101 HEALTH CLAIMS ADMINSTRATION 888784 2 EMPLOYER CONTRIBUTIONS 525100 18706908 18706908 PARTICIPANT AND COBRA 525100 741390 741390 STOP-LOSS REFUNDS 525100 117802 117802 19566100 334286 334286 23531585 23503065 28520 28520 28520 Express Scripts Rebate 900099 196219 196219 misc. income 900099 24694 24694 220913 20149819 19566100 0 583719 11000 20483479 33144 55893 97980 58641 948241 35007 15063 10948 21749396 3973037 2187752 3119072 2866272 93258 14092 13507296 14341124 436373 576890 21129036 19986130 79518 66975 278 48181 79796 115156 X 0 0 0 0 21049240 19870974 21049240 19870974 21129036 19986130 X 0 1 1 X 0 0 DUE TO RELATED FUNDS 48181 48181 20149819 21749396 -1599577 421311 421311 -1178266 20316270 421311 421311 19894959 58641 196219 254860 20149819 21494536 0 21494536 58641 196219 254860 21749396 Part XII, Line 4b - Other Adjustments: REBATE INCOME Part XIII, Line 4b - Other Adjustments: rebate income 1 4 PAWS FOR ABILITY INC 207 Dayton Ave Xenia OH 45385 311625484 501(c)(3) 11000 Charitable Contribution 1 Form 990, Part VI, Section B, line 11 PAINTERS DISTRICT COUNCIL 711 HEALTH AND WELFARE FUND'S FORM 990 IS PREPARED BY ITS INDEPENDENT PUBLIC ACCOUNTANT. THE FORM IS FORWARDED TO THE FUND'S THIRD PARTY ADMINISTRATOR FOR REVIEW. THE ADMINISTRATOR THEN PRESENTS THE RETURN TO THE BOARD OF TRUSTEES FOR SIGNATURE. Form 990, Part VI, Section C, line 19 PAINTERS DISTRICT COUNCIL 711 HEALTH AND WELFARE FUND MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part VII Contact Addresses for Officers, Directors, Etc harry harchetts - 2116 OCEAN HEIGHTS AVENUE, EGG HARBOR TOWNSHIP, NJ 08234. KENNETH EMMONS - 2116 OCEAN HEIGHTS AVENUE, EGG HARBOR TOWNSHIP, NJ 08234. joseph estevez - 9-B FADEM ROAD, SPRINGFIELD, NJ 07081. MICHAEL KISIELEWSKI - 14 HIGH STREET, GLASSBORO, NJ 08028. VINCENT LANE - 122 DRUMMOND AVENUE, NEPTUNE, NJ 07753. CLEMENT SOMMERS - 41 SENECA PLACE, OCEANPORT, NJ 07757. JOHN ANDERSEN - 368 PASSAIC AVENUE, FAIRFIELD, NJ 07004. THOMAS CIRIGNANO - 750 W CALIFORNIA AVENUE, ABSECON, NJ 08201. CHARLES KOMOROSKI III - 1050 ELIZABETH AVENUE, ELIZABETH, NJ 07201. ROBERT SUCHODOLSKY - 125 CLEARVIEW ROAD, EDISON, NJ 08818. PAINTERS DISTRICT COUNCIL 711 HEALTH AND WELFARE FUND'S BOARD OF TRUSTEES IS RESPONSIBLE FOR OVERSEEING THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT WHO PERFORMS THE AUDIT. PAINTERS DISTRICT COUNCIL 711 VACATION FUND 27 ROLAND AVENUE SUITE 200 MOUNT LAUREL NJ 08054 223168980 VACATION BENEFITS NJ 501(C)(9) PAINTERS DISTRICT COUNCIL 711 finishing trades institute of nj 27 ROLAND AVENUE SUITE 200 MOUNT LAUREL NJ 08054 223051963 EDUCATION AND TRAINING NJ 501(C)(3) 170(B)(1)(A)(II) PAINTERS DISTRICT COUNCIL 711 JOINT TRADE BOaRD 2116 OCEAN HEIGHTS AVENUE EGG HARBOR TWP NJ 08234 223052615 LABOR ORGANIZATION NJ 501(C)(5) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PAINTERS DISTRICT COUNCIL 711 VACATION FUND Q 2283915 PAINTERS DISTRICT COUNCIL 711 FINISHING TRADES INSTITUTE OF NEW JERSEY Q 1656543